The arch bar has been the mainstay for the management of maxillo-mandibular bone injuries for an extensive period of time. The originators of such arch bars and their method of use, Sauer in Germany and Gilmer in the United States, utilized an ordinary round bar which was ligated to the teeth of the patient by means of brass ligature wires. Subsequently, a modification of the original arch bar technique by Blair and Ivey resulted in a bar flattened on one side and about 2 mm in width to conform better to the teeth and provide greater stability. Little has changed since the introduction of this arch bar. In spite of its simplicity and reliability, there are numerous problems associated with its utilization.
The application of the arch bar via circumdental wiring, requires local anesthesia regardless of the location of the fracture and is often time consuming and uncomfortable for the patient. Furthermore, securing the arch bar to isolated posterior teeth can be difficult. One of the main failings of the bar technique results from improper adaptation of the appliance whereby teeth may be moved orthodontioally in a lateral or extrusive direction. The incisor teeth are the most vulnerable.
Periodontal injury is always a threat since the wires must often be placed below the gingival margins in order to guarantee stability and with tightening there is a tendency for the appliance to be displaced apioally, resulting in gingival impingement. With the inherent difficulty of maintaining proper oral hygiene and the necessity at times to penetrate the interdental papilla with the circumdental wire when there are tight interproximal embrasures, some degree of gingival inflammation and damage can be expected.
In cases of mandibular fractures, the actual tightening of the wires to the arch bar may be injurious. During this procedure, constant tension must be applied to the wire and occasionally a hard pull must be given to the wire take up the slack, further distracting the fracture margins and possibly complicating the displacement.
The acid etch technique developed by Buonocore, using orthophosphoric acid in 1955 established the foundation for direct bonding procedures for orthodontic brackets. In 1970 Retief, et aI. reported on the direct bonding of orthodontic attachments and in 1978 the acid etch and direct bonding technique for orthodontic brackets was acknowledged in a publication by Newman. The present invention involves an extension of the acid etch and direct bonding techniques to arch bars, thus achieving improvements in maxillo-mandibular surgical procedures.
It is therefore a feature of the present invention to provide a novel arch bar construction facilitating direct bonding of arch bars to the teeth of patients to facilitate the management of maxillo-mandibular injuries.
It is another feature of this invention to provide a novel arch bar construction enabling efficient bonding of the arch bar to the teeth of the patient by means of photopolymerizing bonding agent for positive assurance of arch bar placement prior to setting of the bond by application of light to the bonding agent.
It is also a feature of this invention to provide a novel arch bar construction incorporating a mesh backing for the arch bar that provides efficient retention of the arch bar to the bonding agent.
Other and further features of this invention will become obvious upon a review of the disclosure embodied herewith.